It’s embarrassing for me to write this letter to you because this is the first time I will admit to anyone that my husband and I have anal sex. I actually am getting past the pain, and learning to enjoy it. A friend told me that you can eventually get colon cancer and other things from letting a man come inside your butt, is this true?

–A Little Scared

Please don’t be embarrassed by your admission and know that there are tons of other people having anal sex out there! Let’s talk about the risks of a man ejaculating inside your ass. The ass is made of delicate tissue that can have minute tears in it, allowing easy access to the bloodstream. If you are monogamous and he has tested negative for sexually transmitted diseases (STDs), then he can come in your ass. If you are not monogamous or don’t know his STD status, then, by having unprotected anal sex and ejaculating in your ass, he can transmit gonorrhea, chlamydia, syphilis, herpes, human papilloma virus (HPV) also called anal warts, HIV, or hepatitis.

There isn’t any definitive link between semen in your butt and colon cancer. However, according to the National Cancer Institute, contracting HPV in the ass (anal warts) can increase your chances of colon cancer. Some studies suggest that other STDs and trauma to the anal canal and rectum — the kind that would result from not using lube or warming the ass up properly — can also lead to rectal or colon cancer.